Veterans with back pain have treatment options

There’s a revolution in the treatment of back pain now that research shows that physical therapy, spinal manipulation and yoga can help as much as surgery or drugs—with far fewer risks. That advice is backed up by a new nationally representative Consumer Reports survey of 3,562 back-pain sufferers.

It found that more than 80 percent of those who had tried yoga or tai chi or had seen a massage therapist or chiropractor said it had helped them. Altogether, a higher percentage of people in our survey who saw a yoga or tai chi instructor, massage therapist, chiropractor, or physical therapist said the advice or treatment was helpful compared with those who said they saw a doctor.

Injured back as combat soldier in Vietnam

One of these individuals is Army Veteran Thomas Sells. Note that a typical week for Sells includes acupuncture, tai chi, yoga, and a couple of hours with a massage therapist and sometimes a chiropractor. You might think that the retired bank vice president and business manager in Southern California is simply enjoying a pampered spa lifestyle. But Sells gets most of those services through the Department of Veterans Affairs— all for his aching back.

Those VA programs are more necessity than luxury, says Sells, who first injured his back carrying heavy packs as a combat soldier in the Vietnam War. “None of these therapies were available to me back then,” he explains. “Had I known then what I know now, I could have avoided decades of debilitating pain.”

It used to be that those treatments were considered fringe, but no more. Growing research shows that a combination of hands on therapies and other nondrug measures can be just as effective as more traditional forms of back care, including drugs and surgery. And they’re much safer.

“Tai chi helps with back pain in several ways,” says Benjamin Kligler, M.D., national director of the Integrative Health Coordinating Center at the Veteran’s Health Administration. “It strengthens the muscles in your abdomen and pelvic area that are crucial to supporting the lower back; it improves your balance and flexibility; and it makes you more aware of your posture when you sit, stand, and walk.”

Back pain strikes most of us at some point. It’s one of the main reasons people go to a doctor, accounting for more than 24 million visits each year in the U.S., according to the Centers for Disease Control and Prevention. More than one of four in our survey said that an episode of back pain “severely” interfered with their daily life.

But there’s good news. “Even though back pain can be severe at first, it almost always gets better,” says Kligler. But “what has been considered ‘conventional’ care, including prescribing opioid pain medication, can short-circuit healing,” he says.

I feel better now than I did as a much younger man.”

These drugs include opioids such as hydrocodone and oxycodone. As a young combat soldier, Sells says he turned to alcohol and illegal drugs to numb his back pain. “That took me down a dangerous road,” he recalls. “I became addicted.” With help from recovery programs, he says he has been clean and sober for 30 years. But even with his attempts to self-medicate, his low-back pain continued to worsen over time.

“It became so bad I could barely walk,” Sells says. “I consulted with surgeons but I worried about the risks, and given my history, I didn’t want to take opioids.” Instead, he looked for something safer, and came across a class at VA in tai chi, which combines slow, gentle movements with deep breathing and meditation.

Soon he noticed improvements, gradually adding more exercise and hands-on therapies, which he says manage his pain while keeping his “mind, body, and spirit strong.” And he’s become so good at tai chi that he now studies with a grand master. “It’s given me back my life,” Sells says.

Success stories like this, combined with new research, convinced the agency to make nondrug therapies a foundation of its pain treatment strategy. As a result, VA has cut overall opioid use by 25 percent since 2012, according to a March 2017 analysis published in JAMA Internal Medicine.

Thomas Sells says that a combination of approaches has worked for him. “I feel better now than I did as a much younger man,” he notes. “Mentally, physically, and spiritually, I’m in the best place in my life.”